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Doctor's 'unacceptable' treatment may have caused early deaths of at least 4 patients: B.C. Cancer Agency

Holly Hill and partner Sterling Roberts in 2011: Grateful for unorthodox, even experimental treatment to fight stomach cancer that claimed her life this year.

VANCOUVER - A prominent American oncologist — once considered a star recruit to B.C.'s Centre for the North cancer treatment facility — misdiagnosed or used incorrect methods to treat dozens of cancer patients while he was employed in Prince George and may have caused the early deaths of at least four people under his care, an investigation by the BC Cancer Agency has concluded.

Dr. Suresh Katakkar, who rejects the allegations, worked in Prince George as a medical oncologist from Jan. 24, 2011 to June 12, 2012. In that time, he treated more than 540 cancer patients.

Last May, the BC Cancer Agency moved to suspend the doctor after learning he'd used controversial and unapproved cancer-fighting methods to treat a young patient, Holly Hill, who was in the final stages of terminal gastric cancer.

Hill, the daughter of former Conservative MP Jay Hill, died May 11 at the age of 33.

The agency's concerns over the doctor's unorthodox treatment methods in Hill's case triggered a review of hundreds of Katakkar's patient files.

The results of that review were made public Thursday, nearly one year after the investigation began.

It found that 54 patients, about 10 per cent of Katakkar's total caseload, had received what the agency called "non-standard and unacceptable levels of care."

According to Dr. Max Coppes, agency president, that means the treatment offered to patients either did not meet standards used by oncologists around the country to deal with specific tumours or worse, that its validity was not supported by medical evidence anywhere in the world.

More damning, the review found that treatment given to patients in eight of the 54 cases may have resulted in "severe" and "preventable harm," such as more or worse side effects than usual and, potentially, failing to prevent the cancer from returning.

The most serious cases involved four patients whose deaths were found to be both "potentially preventable" and "treatment-related."

Dr. Marianne Taylor, the agency's head of medical oncology, said treatment offered in those four cases may have "potentially led to death being sooner than expected."

The agency said though patients in the remaining 42 cases received "non-standard and unacceptable levels of care, it did not appear to result in harm to those patients."

According to the agency, the prevalent issues that emerged from the review are:

In an email to The Sun, Katakkar denied the findings of the report, but declined further comment noting the matter is in the hands of legal counsel in Vancouver.

"I have no comments other than I am innocent," he said.

Coppes said patients with "significant care concerns," including the family members of those who died, have all been contacted directly about the findings. He said privacy concerns prevented him from revealing details of those discussions but, in general, "patients and families expressed gratitude that we were willing to sit down with them and be transparent (with the process)."

Coppes, a pediatric oncologist who took over the agency's top job last summer, said the primary purpose of the investigation was to determine what exactly happened to patients under Katakkar's care, but there were also important lessons to be learned. Among them, the agency found a lack of supervision over Katakkar's work — including the absence of a performance review — contributed to the patient outcomes.

The review also found Katakkar's workload management was "problematic," patient documentation was missing or incomplete and he operated a "solo practice" with minimal participation in consultation and case discussion with peers.

Asked how things could get so bad, Coppes responded: "You don't know what you don't know.

"For me the issue is not just to make sure things (like this) don't happen again in Prince George, but that they don't happen in Vancouver or anywhere else. The standards of quality and safety should be the same everywhere in the province," he said.

The agency has since forwarded the investigation results on to the College of Physicians and Surgeons of B.C. for its own review.

Spokeswoman for the college, Susan Prins, confirmed via email the organization has seen the final report. But, she said, the college has ruled it will not pursue an independent investigation because Katakkar no longer works in British Columbia and is not licensed with the college.

"If Dr. Katakkar chooses to re-apply for a license in B.C., he would be required to address all of the issues contained in the report, and the college would conduct its own investigation and come to its own conclusions prior to ever considering a reinstatement of his license," Prins wrote.

Katakkar quit his job with the cancer agency in Prince George last June and has since returned to private practice in Tucson, Arizona.

Hill's family, meanwhile, remains among Katakkar's most-outspoken supporters. Jay Hill, now a private consultant in Calgary, said no one from the cancer agency contacted him about the findings of the report, adding he found it upsetting to learn what was being said about his daughter's doctor through media reports.

Hill said Katakkar was the only doctor willing to try to save Holly's life, when the cancer agency had "written her off" early in her treatment.

Under Katakkar's care, Holly received several different forms of cancer treatments, all of which were approved by the cancer agency. It was only after those treatments had failed that Katakkar offered a radical option: an experimental vaccine he made himself using the patient's own cancer cells, combined with a chemotherapy drug more often used to fight colorectal cancers.

Neither the vaccine nor the chemo had received the necessary approval from the cancer agency, nor was the vaccine recognized by any other agency in the world.

Jay Hill said his daughter knew what she was getting into, and readily agreed to the treatment, though the outcome was uncertain.

"They (the cancer agency) felt she was terminal from the beginning anyway," Hill said. "The only person from the medical profession that hadn't given up on her was Dr. Katakkar."

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